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Pediatric and Adolescent Gynecology—Toward Better Sexual and Reproductive Health
Table 1: Diseases Seen at the Division of Pediatric and Adolescent Figure 1: Ultrasound Imaging Showing the Successful Result of the
Gynecology, 2nd Department of Obstetrics and Gynecology, Formation of a Neovagina Following the Creatsas Vaginoplasty
5
University of Athens Medical School
Period Disease Percentage
Neonate Ambiguous genitalia 97
Vulvitis 2
Congenital malformations (genital) 1
Childhood Vulvovaginitis 80
Premature puberty 9
Vaginal bleeding 5
Congenital malformations (genital) 3
Other (vulva lesions, tumors, etc.) 3
Adolescence Menstrual irregularities 63
Congenital malformations (genital) 12
Genital tract infections 8
Genetic disorders (gonadal dysgenesis, etc.) 5
Other 12
President is Professor Ramiro-Molina Cartez (Chile). Distinguished personalities
such as Professors Dobzay (Hungary), Peter (Czech Republic), Huffman (US),
Dewhurst (UK), and others have contributed their outstanding experience for
Figure 2: The Pediatric and Adolescent Gynecology Unit
the benefit of young women’s health. Today, a significant number of
Reception
colleagues operate PAG services around the world, and I express my gratitude
Midwife
for their kind collaboration over the last 25 years.
6 Nurse
In 1997, the first author of this article instigated the International Fellowship
PAG unit
on Paediatric and Adolescent Gynaecology (IFEPAG), supported by the FIGIJ. In
1999, Professor Ramiro-Molina Cartez became the Director of the IFEPAG; the
current Director is Professor Mendez Ribas, from Buenos Aires. The fellowship
is available in two parts and is provided by the FIGIJ (after training in recognized
Examination
Counseling
PAG centers) to obstetricians–gynecologists, pediatricians, endocrinologists, Pediatric gynecologist Psychologist
and pediatric surgeons. Part II presupposes surgical training in PAG centers and
General practitioner Social worker
Pediatrician
is available only for obstetricians–gynecologists and pediatric surgeons. Upon Pediatric urologist
completion of training, candidates proceed to the IFEPAG examinations, which
Endocrinologist
Geneticist
take place during the European and World FIGIJ Congresses. In 2004, the 14th
World Congress of the FIGIJ took place in Athens, Greece, coinciding with the
Olympic Games. Thus, the main topic of the congress was young female adolescent contraception, the results show a high number of published articles.
athletes. The most recent World Congresses were held this year in Sao Paulo Therefore, it can be concluded that broad areas of research exist for young
and St Petersburg. physicians willing to work and present new protocols on PAG. In any case,
continuing medical education on PAG is fundamental in order to improve
Three more questions remain to be answered before we close this short research and education for the benefit of our patients. Third, how can the
review. First, what are young women’s attitudes to the above? How well do adolescent’s sexual and reproductive health be preserved? National PAG
they accept the first and the subsequent periodic gynecological examinations? societies, the FIGIJ, and other non-governmental organizations should
Adolescents usually hesitate to accept a gynecological examination. For this continue with their efforts to promote sexual and reproductive health among
reason, a painless examination should be promoted. The adolescent’s opinion adolescents. Looking at the past, it is clear that successful efforts have been
should be taken into account and her questions should be carefully answered. undertaken and that better results can be expected from countries where
Physicians in PAG centers should discuss and respect adolescent ‘secrets’ and young people have understood the importance of prevention of diseases that
needs. They should also try to develop a pleasant atmosphere between may lead to serious gynecological problems. For this reason, it is recommended
the adolescents and their parents in order to improve compliance so that that young people visit PAG and family planning centers for preventive reasons,
adolescents will be happy to return for re-examination. Second, what is especially if symptoms are present. ■
the future of PAG? From observing the electronic databases, it is clear that the
number of publications on PAG is not high. However, if we also include For further information about the IFEPAG, please contact Professor Mendez
publications related to endocrinology, molecular biology, genital infections, and Ribas at jmmendezr@intramed.net.ar
1. Creatsas G, Eur J Obstet Gynecol, 1995;58:107–9. 3. Creatsas G, et al., Fertil Steril, 2001;76(5):1036–40. 5. Botsis D, et al., Int J Gynaecol Obstet, 2005;89:31–4.6.
2. Creatsas G, Deligeoroglou E, Eur J Obstet Gynecol Reprod Biol, 4. Deligeoroglou E, et al., Fertil Steril, 2005;83:1547–8. CreatsasG, FIGIJ Bulletin, Athens, 1994.
2007;131:248–52.
US OBSTETRICS & GYNECOLOGY 13
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